Study Description
This is a phase I/II study to evaluate the feasibility, safety and preliminary antitumor
efficacy of rapcabtagene autoleucel (also known as YTB323). Rapcabtagene autoleucel will
be investigated in combination with ibrutinib in chronic lymphocytic leukemia (CLL)/small
lymphocytic lymphoma (SLL) and as single agent in diffuse large B-cell lymphoma (3L+
DLBCL), adult acute lymphoblastic leukemia (ALL) and 1st Line High Risk Large B-Cell
Lymphoma (1L HR LBCL). This clinical trial is phase I/II open label, multi-center study of rapcabtagene
autoleucel.
The Phase I part of the study comprises three independent treatment arms:
- Rapcabtagene autoleucel in combination with ibrutinib in adult CLL/SLL participants
with SD or PR after at least 6 months of second or subsequent line ibrutinib
therapy. As of 05-May-2021, this arm had completed enrollment.
- Rapcabtagene autoleucel single agent in adult DLBCL participants having failed two
or more lines of chemotherapy and either having progressed (or relapsed) after
autologous HSCT or being ineligible for or not consenting to the procedure.
- Rapcabtagene autoleucel single agent in adult relapsed/refractory ALL participants
The Phase II part of the study comprises two independent cohorts:
- Rapcabtagene autoleucel single agent in adult 3L + DLBCL participants having failed
two or more lines of chemoimmunotherapy and either having progressed (or relapsed)
after autologous HSCT or being ineligible for or not consenting to the procedure.
This is an extension of the Phase I r/r DLBCL treatment arm to support Phase II
objectives
- Rapcabtagene autoleucel single agent in newly diagnosed, adult 1L HR LBCL
participants defined as IPI 3-5 and/or DH/TH disease who have completed 2 cycles of
CIT and have a response of PR/SD (with a Deauville score of 4-5).
In the Phase I part of the trial, the 3L+ DLBCL and ALL arms consist of two parts: a dose
escalation part to evaluate feasibility, characterize safety and identify the recommended
dose (RD) of rapcabtagene autoleucel, and a dose expansion part to further characterize
safety, study rapcabtagene autoleucel cellular kinetics and assess preliminary antitumor
activity. Once the RD of rapcabtagene autoleucel is determined for each arm, the
corresponding expansion part will commence.
In the Phase II part of the trial, approximately 70 additional participants will be
enrolled in a 3L+ DLBCL cohort treated at the recommended dose (RD). Including the 3L+
DLBCL participants who were treated at the RD from the Phase I part, it is planned to
have in total a cohort of approximately 100 participants included in the primary efficacy
analysis based on the efficacy analysis set. In addition, a separate cohort in 1LHR LBCL
will be included, with approximately 50-60 participants planned for the primary efficacy
analysis based on the efficacy analysis set.
Participants will be followed under the current treatment protocol for safety and
efficacy within this trial for a minimum of 2 years before being transferred to the
long-term follow-up trial. Once the study is complete, participants will be enrolled in a
post-study long term follow-up for lentiviral vector safety for up to 15 years. This
post-study long term follow-up for lentiviral vector safety will continue under a
separate destination protocol.
Interventions
Ibrutinib
Rapcabtagene autoleucel single agent
Eligibility Criteria
Inclusion Criteria:
- ECOG performance status 0-1 for ALL and DLBCL
- ECOG performance status 0-2 for 1L HR LBCL at screening
- CLL or SLL diagnosis according to iwCLL criteria
- CLL/SLL in SD or PR after at least 6 months of ibrutinib, either as second or
subsequent line of therapy
- DLBCL diagnosis by local histopathology
- DLBCL relapsed or refractory after 2 or more lines of therapy, including autologous
hematopoietic stem cell transplantation (HSCT)
- Refractory or relapsed CD19-positive ALL
- ALL with morphologic disease in the bone marrow
1L HR LBCL - Considered to be high-risk based on at least 1 of the following at
diagnosis:
- IPI score of 3, 4 or 5
- MYC and BCL2 and/or BCL6 rearrangement (DH/TH lymphoma)
- Participants must have received 2 cycles of frontline therapy for LBCL with R-CHOP
or Pola-R-CHP or DA-EPOCH-R. Participants with DH/TH lymphoma must have received at
least one cycle (the most recent) DA-EPOCH-R.
- Participants must have a positive PET per Lugano classification (Deauville PET score
of 4 or 5 and an overall response of PR/SD) after 2 cycles of frontline CIT. Note:
Patient's with Deauville PET score of 5 and overall response of PD, or with
Deauville PET score of 1, 2, or 3 and overall response of CR, are not eligible for
this trial.
Exclusion Criteria:
- Prior CD19-directed therapy
- Prior administration of a genetically engineered cellular product
- Prior allogeneic HSCT
- Richter's transformation
- For 1L HR LBCL: Richter's transformation, Burkitt lymphoma, primary DLBCL of
CNS, DLBCL associated with chronic inflammation, intravascular large B-cell
lymphoma, ALK- positive large B-cell lymphoma, HHV8 positive LBCL, DLBCL leg
type or EBV positive DLBCL, NOS.
- Active CNS lymphoma
- For 1L HR LBCL: Active CNS involvement by malignancy
- Targeted small molecule or kinase inhibitor within 2 weeks from leukapheresis
Other protocol-defined inclusion/exclusion may apply.
Novartis Investigative Site
Recruiting
Melbourne,Victoria,3000,Australia
Novartis Investigative Site
Recruiting
Melbourne,Victoria,3004,Australia
Novartis Investigative Site
Recruiting
Wien,A-1090,Austria
Novartis Investigative Site
Recruiting
Pierre Benite,69495,France
Novartis Investigative Site
Recruiting
Rennes,35019,France
Novartis Investigative Site
Recruiting
Marseille,13273,France
Novartis Investigative Site
Recruiting
Paris 10,75475,France
Novartis Investigative Site
Recruiting
Essen,45147,Germany
Novartis Investigative Site
Recruiting
Frankfurt,60590,Germany
Novartis Investigative Site
Recruiting
Koeln,50937,Germany
Novartis Investigative Site
Recruiting
Leipzig,04103,Germany
Novartis Investigative Site
Recruiting
Bologna,BO,40138,Italy
Novartis Investigative Site
Recruiting
Milano,MI,20132,Italy
Novartis Investigative Site
Recruiting
Rozzano,MI,20089,Italy
Novartis Investigative Site
Recruiting
Bergamo,BG,24128,Italy
Novartis Investigative Site
Recruiting
Fukuoka city,Fukuoka,812-8582,Japan
Novartis Investigative Site
Recruiting
Sapporo city,Hokkaido,060 8648,Japan
Novartis Investigative Site
Recruiting
Bunkyo ku,Tokyo,113-8677,Japan
Novartis Investigative Site
Recruiting
Valencia,Comunidad Valenciana,46010,Spain
Novartis Investigative Site
Recruiting
Cordoba,Andalucia,14004,Spain
Novartis Investigative Site
Recruiting
Barcelona,08041,Spain
Novartis Investigative Site
Recruiting
Sevilla,Andalucia,41013,Spain
Novartis Investigative Site
Recruiting
Madrid,28009,Spain
Novartis Investigative Site
Recruiting
Salamanca,Castilla Y Leon,37007,Spain
Novartis Investigative Site
Recruiting
Badalona,Catalunya,08916,Spain
Novartis Investigative Site
Recruiting
Madrid,28041,Spain
Novartis Investigative Site
Recruiting
Barcelona,Catalunya,08035,Spain
Novartis Investigative Site
Recruiting
Hospitalet de LLobregat,Catalunya,08907,Spain
Sarah Cannon Research Institute Methodist Hospital
Recruiting
Nashville,Tennessee,37221,United States
Paul Shaughnessy
Tiarra Walker
Stanford University Medical Center
Recruiting
Stanford,California,94305-5826,United States
Saurabh Dahiya
Montefiore Medical Center .
Recruiting
Bronx,New York,10461,United States
Dennis Cooper
Medical College of Wisconsin Main Centre
Recruiting
Milwaukee,Wisconsin,53226,United States
Nirav Shah
Uni of Chi Medi Ctr Hema and Onco
Recruiting
Chicago,Illinois,60637,United States
Peter Riedell
H Lee Moffitt Cancer Center and Research Institute .
Recruiting
Tampa,Florida,33612,United States
Julio Chavez
St Davids South Austin Medical Ctr
Recruiting
Austin,Texas,78704,United States
Aravind Ramakrishnan
University of Pennsylvania Clinical Perelman Center for Adv Med
Recruiting
Philadelphia,Pennsylvania,19104,United States
Noelle Frey
University of Kansas Cancer Center SC - CTL019C2201
Recruiting
Westwood,Kansas,66205,United States
Leyla Shune
Northside Hospital .
Recruiting
Atlanta,Georgia,30342,United States
Scott D. Solomon
University Of California LA UCLA Hematology Oncology
Recruiting
Los Angeles,California,90095,United States
Patricia Young
Uni of TX MD Anderson Cancer Cntr
Recruiting
Houston,Texas,77030,United States
Jason Westin
Sarah Cannon Research Institute Drug Ship - 4
Recruiting
Nashville,Tennessee,37203,United States
Ian W. Flinn
Mass Gen Hosp Cancer Center .
Recruiting
Boston,Massachusetts,02114,United States
Patrick Connor Johnson
Northwestern University Northwestern Memorial Hospital Trans
Recruiting
Chicago,Illinois,60611,United States
Holly Roberta Krieg
Shira Dinner
Worldwide Contacts
If the location of your choosing does not feature any contact detail, please reach out using the information below.